J Breast Cancer.  2017 Jun;20(2):203-207. 10.4048/jbc.2017.20.2.203.

Influence of the Angelina Jolie Announcement and Insurance Reimbursement on Practice Patterns for Hereditary Breast Cancer

• Lee J
• Kim S
• Kang E
• Park S
• Kim Z
• Lee MH
• The Korean Breast Cancer Society

• KMID: 2389759
• DOI: http://doi.org/10.4048/jbc.2017.20.2.203

Abstract

Lack of awareness, the stigma of carrying a genetic mutation, and economic factors are barriers to acceptance of BRCA genetic testing or appropriate risk management. We aimed to investigate the influence of Angelina Jolie's announcement of her medical experience and also health insurance reimbursement for BRCA gene testing on practice patterns for hereditary breast and ovarian cancer (HBOC). A survey regarding changes in practice patterns for HBOC before and after the announcement was conducted online. The rate of BRCA gene testing was obtained from the National Health Insurance Review and Assessment Service database. From May to August 2016, 70 physicians responded to the survey. Genetic testing recommendations and prophylactic management were increased after the announcement. Risk-reducing salpingo-oophorectomy and contralateral prophylactic mastectomy was significantly increased in BRCA carriers with breast cancer. The BRCA testing rate increased annually. Health insurance and a celebrity announcement were associated with increased genetic testing.

Keyword

Breast neoplasms; Genetic testing; Insurance coverage; Practice patterns; Prophylactic mastectomy

MeSH Terms

Breast Neoplasms*
Breast*
Genetic Testing
Insurance Coverage
Insurance*
Insurance, Health
Insurance, Health, Reimbursement
Mastectomy
National Health Programs
Ovarian Neoplasms
Risk Management

Figure

• 

  Figure 1 Annual trend of BRCA gene testing prescription. (A) Annual patient numbers who received BRCA1 and BRCA2 genetic testing. (B) Annual BRCA1 testing numbers by level of care from 2010 to 2015. p-value represents for trend test. NA=not available.

• 

  Figure 2 Number of BRCA1 prescription by age group from 2010 to 2015. Age of 30' in women showed the highest testing rate.

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